Prevention of posterior capsule opacification using capsular tension ring for zonular defects in cataract surgery.

PURPOSE: To evaluate the incidence of secondary cataract in phacoemulsification and intraocular lens implantation using a capsular tension ring in case of zonular dehiscence. METHODS: Phacoemulsification using a double capsular tension ring and intraocular lens implantation was done in 65 eyes with cataract and severe zonular weakness. One year after surgery capsular opacities and fibrosis were detected in a double-blind examination. The results were compared with a control group of 36 eyes that did not have a capsular tension ring but had similar surgery. RESULTS: In the group with the capsular tension ring and implantation 7.7% of patients had moderate or severe posterior capsule opacification, compared with 36.1% in the control group. CONCLUSIONS: Capsular tension rings may influence the formation of capsule opacification.

Rapidly growing choroidal metastasis: case report.

A rapidly growing choroidal metastasis from an occult carcinoma is described. The patient was first seen with a loss of visual acuity. The fundus examination showed a non-pigmented solid mass located at the posterior pole. Clinical history, echographic characteristics and tumour growth kinetics are described in detail.

Echographic evaluation of choroidal melanomas treated with ruthenium-106 plaques: the treatment failures.

From July 1990 to October 1995 we treated 45 patients with choroidal melanomas using ruthenium-106 plaques. The population mean age was 59.2+/-10.4 years. In this paper, the authors describe in detail their clinical management and follow-up timing. They also report on the echographic pattern change after treatment and the clinical history of some failure cases.

Orbital metastases: echographic findings our experience.

In this paper the authors examine the echographic findings in 20 patients with metastatic and secondary tumors of the orbit observed at the University Eye Clinic of Ferrara (Italy) between January 1985 and August 1995. The aim of this study is to identify some typical echographic characteristics in these forms and to underline the diagnostic role of orbital echography.

Posterior scleritis: ultrasound findings in two cases.

Two cases of posterior inflammatory scleritis are described. The authors show the echographic findings, pointing out the helpfulness of diagnostic ultrasound and the crucial role in monitoring these diseases with A scan examinations to obtain clear results of therapy, even if subjective symptoms disappear.

Immersion technique in anterior-segment examination.

Ultrabiomicroscopy, using equipment with high-frequency transducers, is a very simple method for the study of superficial ocular structures. Nevertheless, these equipment are very expensive and not commonly used. The most widespread and used instrumentations are still provided with lower-frequency probes. These are sufficient to show the anterior segment of the eye. In this work we underline the diagnostic importance of this method and, in some cases, the therapeutic role.

Effects on the corneal endothelium six months following photorefractive keratectomy.

Photorefractive keratectomy (PRK) with a 193-nm excimer laser has been shown not to destroy endothelial cells in vivo. However, this laser could damage endothelial cell metabolism, and result in damage over a longer term. In this paper, a comparison between the number and shape of corneal endothelial cells has been performed in 25 patients before and 6 months after PRK. These patients underwent treatment with myopic correction ranging from 2.5 to 17 dpt and with an estimated corneal thinning ranging from 25 to 170 microns. No significant changes in the number (p = 0.167) and shape (p = 0.075) of endothelial cells have been found. These results show that there are no long-term damages after PRK even in severely myopic eyes.

Phenotypic variation in combined granular-lattice (Avellino) corneal dystrophy.

OBJECTIVE: To describe the phenotypic variation exhibited by members of families with combined granular-lattice (Avellino) corneal dystrophy. SETTING: We examined 40 patients (age range, 12 to 85 years) from six unrelated families with Avellino corneal dystrophy. This included the first individuals to ever be examined near the presumed site of origin in Italy. In addition, one family was the first to trace its origins to Germany rather than to Italy. We studied the phenotypic expression of the disease in the cornea, visual acuities, subjective complaints, complications, treatment, and histologic condition of these individuals. RESULTS: The granular stromal lesions reach their mature quantity and size early in life, and appear as either gray and crumb-shaped deposits or superficial with an annular and planar distribution. The lattice component appears gradually, beginning and maturing later in life. The phenotypic variation within families was found to be substantial. Widely variable proportions of lattice and granular changes were found within single sibships. Visual acuities ranged from 20/20 to 20/400. Recurrent corneal erosions were present but infrequent. Subjective complaints included glare and decreased night vision. Penetrating keratoplasty was required in one individual to restore vision. Histopathologic examination revealed typical amyloid and granular deposits. Granular deposits were found replacing Bowman's membrane and extending to the corneal surface. These deposits probably represent the cause of recurrent erosions. CONCLUSIONS: Combined granular and lattice corneal dystrophy may present with substantial phenotypic variation. The disease can be found in individuals who trace their ancestry to both Italy and Germany, a wider geographic distribution than previously proposed.

Echographic and ophthalmodynamometric study in the empty sella syndrome.

A group of patients with empty sella syndrome (ESS) and visual field defect with or without visual loss has been examined with standardized echography and ophthalmodynamometric examination. The optic nerve thickness has been evaluated with standardized echography; the pressure of the central retina artery has been evaluated with ophthalmodynamometric examination with or without compression on the external carotid. Our results point out two different pathogeneses in the ESS: vascular defects or irregular endocranial hypertension.

Standardized A-scan echography and the normal optic nerve. Experience with the new Mini A equipment.

The potential of making differential diagnosis in optic nerve disease with standardized A-Scan echography has been well established. With this technique it is possible to differentiate 'solid' and 'fluid' thickening. A few years ago a new standardized A-scan equipment was built: The Mini A. With this equipment, it is possible to distinguish spikes coming from the pia, the arachnoid, and the dura around the optic nerve, and to measure the thickness of these structures with a precision of 0.03 mm. We found dura distance 4.0-5.3 mm, arachnoid 3.2-4.0 mm, an pial diameter 2.8-3.4 mm. In this paper the authors discuss their preliminary findings in a normal population.